Download An Identification Guide - Sunshine Coast Health Centre

DRUGS
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An Identification Guide
Sunshine Coast
Health Center
Residential Addiction &
Mental Health Treatment Services
www.schc.ca
Sunshine Coast Health Center
Table of Contents
Why This Guide? ...................................................................................... 7
When Drug Use Becomes Drug Dependence..........................................................................7
Drug Categories Explained.............................................................................................................7
Prevalence of Drug Abuse in Canada..........................................................................................7
Class 1: Hallucinogens ............................................................................ 8
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Class 2: Depressants ..............................................................................13
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PCP..........................................................................................................................................................8
Ketamine...............................................................................................................................................8
LSD (Lysergic Acid Diethylamide).................................................................................................9
MDMA.....................................................................................................................................................9
Mescaline or Peyote....................................................................................................................... 10
Psilocybin........................................................................................................................................... 10
STP/DOM/MDA................................................................................................................................ 10
PMA (Paramethoxyamphetamine)........................................................................................... 11
DMT (Dimethyltryptamine)......................................................................................................... 11
2C-B or DOB....................................................................................................................................... 11
DXM (Detromethorphan)............................................................................................................. 11
5-MEO-DIPT....................................................................................................................................... 12
Salvia Divinorum............................................................................................................................. 12
1-(3-Trifluoromethylphenyl) Piperazine (TFMPP)................................................................ 12
Opioid Pain Relievers..................................................................................................................... 13
Opium.................................................................................................................................................. 14
Heroin.................................................................................................................................................. 14
Methadone........................................................................................................................................ 16
Fentanyl.............................................................................................................................................. 16
Prescription Cough Syrup............................................................................................................ 16
Prescription Tranquilizers & Sleeping Pills.............................................................................. 16
GHB....................................................................................................................................................... 17
Inhalants............................................................................................................................................. 17
Alcohol................................................................................................................................................ 18
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Addiction Services Directory
TOLL-FREE HELP LINE
1.877.746.1963
Class 3: Stimulants .................................................................................20
Cocaine............................................................................................................................................... 20
Prescription Stimulants................................................................................................................. 21
Methamphetamine........................................................................................................................ 22
Methcathinone................................................................................................................................ 23
Khat...................................................................................................................................................... 23
canadadrugrehab.ca
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Drug Identification Guide
Sunshine Coast Health Center
Class 4: Anabolic Steroids .....................................................................24
Class 5: Cannabis....................................................................................25
Marijuana........................................................................................................................................... 25
Hashish or Hash Oil......................................................................................................................... 25
Wax, Budder & Shatter................................................................................................................... 25
Medical Use....................................................................................................................................... 25
Spice or K2......................................................................................................................................... 26
Cannabis Paraphernalia................................................................................................................ 26
need help?
Drug Paraphernalia .............................................................................. 28
Drug Containers............................................................................................................................... 28
Smoked Drugs.................................................................................................................................. 28
Injected Drugs.................................................................................................................................. 28
Snorted Drugs.................................................................................................................................. 29
Oral Drugs.......................................................................................................................................... 29
First Aid for a Drug Overdose .............................................................. 29
Types of Drug Overdoses............................................................................................................. 29
History of the Scene....................................................................................................................... 29
Signs and Symptoms of a Drug Overdose............................................................................. 29
General First Aid for a Drug Overdose..................................................................................... 30
Tips to Help Reduce the Risk of Overdose............................................................................. 30
Cannabis:
Page 25
Cannabis
sativa plant
Hallucinogens:
Page 8
Depressants:
Page 13
Black tar
heroin
Source: DEA
Stimulants:
Page 20
LSD on blotter
paper
Powder methamphetamine
in foil
Source: DEA
LEARN MORE ▼
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Drug Identification Guide
Do you need help talking about drug use and addiction prevention with your
class or youth group?
Our presentation discusses safe drug use and addiction prevention.
Use the QR code to download now or contact us at [email protected]
Sunshine Coast Health Center
Why This Guide?
“An ounce of prevention is worth a pound of cure.”
Benjamin Franklin
The key to effective prevention is knowledge. This guide
is designed to educate families, employers, and educators on the vast array of abused drugs now commonplace in our communities. Some of these drugs, such as
inhalants, can be found in any supermarket or hardware
store. Prescription drugs have legitimate medical applications, but are being increasingly diverted for illicit
purposes. Other “hardcore” drugs, such as crack cocaine,
have become regular features in many schools, work
sites, and homes across North America.
When Drug Use Becomes Drug Dependence
Drugs of Abuse: an Identification Guide is a public service publication produced by Sunshine Coast Health Center.
Additional copies of this guide are available from:
Sunshine Coast Health Center, Toll-free number: 1.866.487.9010
This publication is also available in digital format on the Sunshine Coast Health Center web site at: www.schc.ca
SOURCES OF DATA
Drug Enforcement Administration (2005). Drugs of Abuse. US Department of Justice.
Health Canada (2000). Straight Facts About Drugs & Drug Abuse. Minister of Public Works and Government Services Canada
(H39-65/2000E).
Health Canada. (2012). Canadian alcohol and drug use monitoring survey. Retrieved from
http://www.hc-sc.gc.ca/hc-ps/drugs-drogues/stat/_2012/summary-sommaire-eng.php
National Highway Traffic Safety Administration (NHTSA) www.nhtsa.dot.gov
National Institute on Drug Abuse (2006). NIDA InfoFacts. US Department of Health & Human Services www.drugabuse.gov
Canadian Centre on Substance Abuse (2004). Canadian Addiction Survey.
California Highway Patrol www.chp.ca.gov
Disclaimer
This guide is intended to provide you, the reader, with information on drugs of abuse. Readers should be aware that this
publication is not intended and should not be construed to be legal advice. Sunshine Coast Health Center is not responsible for
any problems that may develop from the use or misuse of the information provided in this guide.
Copyright © 2015 by Sunshine Coast Health Centre (2005) Ltd., Powell River, British Columbia V8A 4Z2
All rights reserved. This publication or any part thereof may not be reproduced in any form or by any means without the written
permission of Sunshine Coast Health Center. Please consult the references provided.
6
When drugs are used solely to create intensely pleasurable feelings, it is called drug use. Tolerance to the drugs’
effects occurs with long-term use and users must take
higher doses to achieve the same or similar effects as
experienced initially.
Prolonged drug use can lead to physical dependence,
psychological dependence, or both. Physical dependence means that the absence of the drug creates
discomfort (withdrawal) until more of the drug is
administered. Psychological dependence refers to a
perceived “need” or “craving” for a drug. While physical
dependence is typically treated in a few days, treatment
for psychological dependence is much longer.
Drug Categories Explained
There are four categories of drugs: hallucinogens,
depressants, stimulants, and anabolic steroids. All
controlled substances have the potential to be misused.
With the exception of anabolic steroids, controlled
substances are used to alter mood, thought, and feeling
through their effect on the central nervous system
(brain and spinal cord).
cal uses, effect duration, or methods of ingestion (oral,
injected, smoked, or snorted). However, drugs within a
particular class typically share similar effects, overdose
risk, and withdrawal symptoms.
Although considered a hallucinogen, the prevalence and
unique features of cannabis warrant a separate section.
Inhalants are not controlled substances because of their
widespread use for a number of legitimate purposes,
but are discussed in this guide due to their abuse potential. Families and educators may want to pay particular
attention to inhalants since most users are youth.
Please note we have organized substances listed in this
guide by categories (referred to as classes) to improve
individual and business use. These classes should not
be confused with Canada’s Schedule of Drugs under the
Controlled Drugs and Substances Act.
Prevalence of Drug Use in Canada
Of Canadians 15 years or older, a 2011 survey revealed
that alcohol is, by far, the drug of choice with 78%
reporting alcohol use in the past year. Of past-year
drinkers, 17% are considered high-risk drinkers. Cannabis is the most widely used illicit drug followed in
order by LSD and hallucinogens, cocaine and crack, and
speed. Rates of past-year use of cannabis decreased in
2011 from 2004, going from 14.1% to 9.1%. Cocaine
and crack use also decreased from 1.9% in 2004 to .9%
in 2011. Rates of past-year use for all other substances
(including steroids and inhalants) remained below 1
percent (Source: CADUMS, 2011).
In Canada, tobacco is the leading preventable cause of
death. Its exclusion from this guide is not intended to
minimize its impact on the well-being of Canadians.
Drugs are distinguished by their effect on the central
nervous system (depressants or stimulants), their
primary ingredient (the poppy plant for opioids, testosterone for steroids), and how they are used (inhalants).
Individual drugs within a class can have differing medi7
Drug Identification Guide
Sunshine Coast Health Center
Class 1
• Loss of appetite
• Dry mouth
•Sleeplessness
•Tremors
Drug-induced confusion can cause accidental death.
Long-term effects of some LSD users can include sudden
flashbacks and long-lasting psychoses such as schizophrenia or depression.
HALLUCINOGENS
PCP (phencyclidine)
Angel dust, elephant, hog, rocket fuel (killer weed, supergrass: PCP mixed with marijuana).
A white crystalline powder readily soluble in water
or alcohol with a distinctive bitter chemical taste.
Available in tablets, capsules, liquids, crystals, pastes,
and coloured powders. Is frequently passed off as LSD
and snorted, smoked, or eaten. When smoked, PCP is
often used with a leafy material such as mint, parsley,
oregano, tobacco or marijuana. PCP may be used
unknowingly since it is often an additive in other drugs.
Effects: PCP is a “dissociative drug,” meaning it distorts
perceptions of sight and sound and produces feelings
of detachment from the environment and self. Most
first-time users experience a “bad trip” and stop. Low
dose effects include shallow breathing, flushing, and
profuse sweating. High dose effects are nausea, vomiting, blurred vision, flicking up and down of the eyes,
drooling, loss of balance, and dizziness. Speech is often
sparse and garbled. Accidental death can result from
drug-induced confusion. Long-term effects include:
Ecstasy, Adam, E, roll, X, XTC, hug drug, CK, M&Ms.
Manufactured as an injectable liquid or white powder
sold in small baggies or gel capsules. In illicit use Ketamine is evaporated to form a powder that is snorted,
swallowed, or injected. Ketamine is odorless and
tasteless, so it can be added to beverages without being
detected. Induces amnesia and is commonly used as a
“date rape” drug. Popular at “raves” and night clubs.
Effects: A dissociative drug similar to PCP, but with
milder respiratory depression, less confusion, irrationality and violent behaviour. Large doses may result in
intense, unpleasant visual and auditory hallucinations.
Since Ketamine is often mixed with other substances, it
can be hard to determine the long-term effects. Common long-term effects can include:
• Bladder pain and ulcers •Depression
• Kidney problems
• Poor memory
• Stomach pain
Sources: DEA; NIDA InfoFacts
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MDMA
Ketaset®, Ketalar® Cat valium, K, special-K, vitamin K.
•Addiction
•Depression
• Memory loss
• Weight loss
• Cognitive difficulties
Symptoms can persist up to a year after cessation of PCP
use. Mood disorders also have been reported. Flashbacks may occur (see LSD section).
(L) PCP in foil wrappers. (R) PCP tablets. Source: DEA
Sources: DEA; NIDA InfoFacts
Ketamine
Ketamine is manufactured as a liquid or powder. Source: DEA
(T) LSD caps contain bright-coloured powder to attract young
people. (B) Coloured LSD applied to sugar cubes. Source: DEA
LSD (lysergic acid diethylamide)
Blotter, cid, boomers, sunshine, doses, hits, microdot,
sugar cubes, tabs, trips, or named after the image on the
blotter paper.
Manufactured from lysergic acid in ergot, a fungus that
grows on rye and other grains. LSD is usually applied to
“blotter” paper (paper perforated into small squares).
The squares or “tabs” may be coloured or have images
printed on them. Liquid LSD is a clear liquid, usually in a
small container, tube or flask. LSD can also be found in
thin squares of gelatin or applied to sugar cubes. Gelatin
and liquid can be put in the eyes. LSD is taken orally.
Effects:
• Felt within an hour and • Changes in perception of
can last 2-12 hours
time and distance
• Colours can appear
• Impaired short-term
brighter and objects
memory
more sharply defined
• Extreme mood swings
Physical Effects Include:
• Increased heart rate and
• Dilated pupils
blood pressure
• Higher body
temperature
•Sweating
A synthetic drug with amphetamine-like and hallucinogenic properties. MDMA comes in a tablet form that
is often branded (e.g. Playboy bunnies, Nike swoosh,
CK). Considered a “club drug” as MDMA is often taken at
raves, clubs, and other parties. MDMA is also available as a brown/beige powder in small baggies or gel
capsules.
Users report intensely pleasurable effects including enhanced sense of self-confidence, energy, and sociability.
Other Effects:
• Involuntary teeth clenching
• Loss of inhibitions
• Transfixion on sights and sounds
• Nausea, blurred vision, chills and/or sweating
• Increases in heart rate and blood pressure
•Seizures
• Death from kidney or heart failure due to dehydration
or hyperthermia
After-effects can include sleep problems, anxiety, and
depression.
Long-term, repeated use may damage the cells that
produce Serotonin (regulates mood, appetite, pain,
learning and memory). May disrupt or interfere with
memory. Sources: DEA; NIDA InfoFacts
Ecstasy tablets and as a beige/white powder. Source: DEA
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Drug Identification Guide
Sunshine Coast Health Center
Mescaline or Peyote
they can also be sniffed, smoked, or injected. Mushroom
powder is often mixed with fruit juice.
PMA (paramethoxyamphetamine)
Peyote is a small cactus
whose principal active
ingredient is mescaline.
Mescaline can be extracted
from peyote or produced
synthetically. Usually ingested orally as a
powder, tablet, capsule or
liquid. Most peyote and
mescaline sold in Canada
Peyote cactus.
is actually PCP or LSD.
Peyote “buttons” are generally chewed or ground up
and smoked.
Effects: Once ingested, mushrooms generally cause
feelings of nausea before the desired mental effects
appear. Other effects can include nervousness, paranoia,
and distorted senses.
PMA is sold in tablets or capsules containing beige,
white or pink powder and often misrepresented as
MDA. Made in clandestine labs with no medical use.
Looks similar to MDMA. PMA is typically taken orally,
but, although uncommon, may be inhaled or injected.
Buttons, cactus, mesc.
Effects: Effects appear slowly, but can last 10–18
hours. The causes of these effects, which can occur after
a single use, are not known. Most effects are similar to
LSD.
Psilocybin
Magic Mushrooms, mushrooms, shrooms.
Psilocybin is the hallucinogenic principle contained in
certain mushrooms. Psilocybin is structurally similar
to serotonin and produces its effects by disrupting
normal functioning of the serotonin system. Frequently,
Psilocybin is sold in Canada as PCP or LSD. Mushrooms
are typically eaten or brewed and consumed as tea, but
Source: DEA
STP/DOM/MDA
These are chemical variations of amphetamines. They’re
produced in clandestine labs with no medical use. DOM,
nicknamed STP (acronym for “Serenity, Tranquility, and
Peace”), is usually sold as white or off-white powder
that is ingested, sniffed, or injected. MDA is similar to
MDMA (ecstasy) and is usually sold as a brown or white
powder, capsule, or amber liquid, which are taken orally.
Effects: DOM may last 16 to 24 hours. Small doses
produce mild euphoria and talkativeness, while higher
doses produce LSD like effects. Adverse reactions may
result in intense anxiety, panic, and psychosis.
MDA effects occur within an hour and last up to 8
hours. Produces a sense of well-being and heightened
emotions. Pupils dilate and nose and throat become dry.
Higher doses have effects similar to LSD. Overdose can
cause death.
Source: Health Canada
Death, Mitsubishi double stack, chicken yellow.
Effects: Similar to MDA and mescaline, though far
more toxic. Symptoms include:
• Laboured breathing
• Muscle spasms
• High fever
•Vomiting
• Erratic eye movement
Moderate to high doses can lead to convulsions, coma
and death. One of the most dangerous hallucinogens.
Long-term effects are unknown.
Source: DEA
DMT (dimethyltryptamine)
Businessman’s trip.
A hallucinogenic tryptamine. Usually parsley is soaked
in DMT, then dried and smoked. Can also be injected.
Made in clandestine labs.
Effects: Similar effect to LSD, DOM, and MDMA. Hallucinogenic effects last for about 45 to 60 minutes so
the experience is called a “businessman’s trip.” Snorting
hastens effect. May produce nausea, chills, trembling,
cramps, muscle tension, and shallow breathing in
higher doses. Long-term effects are unknown. Source: DEA
2C-B or DOB
Nexus, bromo, toonies, herox, synergy.
Psychoactive or hallucinogenic
compounds similar to mescaline. Pro2C-B tablet.
duced in clandestine labs. Available
Source: Wikipedia
as powder, purple/red or white pills,
yellow capsules, or blotter papers (similar to LSD) that are
taken orally or snorted. Structurally similar to DOM and
has been sold as MDMA and LSD. No medical use.
Effects:
• Intense hallucinations • Increased heartbeat
•Nausea
• Raised blood pressure
•Vomiting
• Confusion or
disorientation
•Diarrhea
• Inability to concentrate
•Gas
•Dehydration
•Delirium
• Muscle tension & spasms
•Headaches
Long-term effects of both 2C-B or DOB are unknown.
Source: DEA
DXM (dextromethorphan)
Dex, robo, DM, velvet, skittles, triple C, tussin.
DXM is a cough-suppressing ingredient found in a
variety of over-the counter cold and cough medications.
Available as a syrup, tablet, or gel cap that is usually
swallowed. DXM can also be purchased in powder form,
often over the internet.
Over the counter
drugs such as
Robitussin® (left)
and Coricidin®
(right) contain DXM.
Whole dried psilocybin.
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Drug Identification Guide
Sunshine Coast Health Center
Class 2
DEPRESSANTS
OPIOID PAIN RELIEVERS
Acetaminophen Oxycodone: Tylox®
Acetaminophen Hydrocodone: Lorcet® Plus, Lortab®
Codeine: Codeine Contin®, Atasol®, Fiorinal®, Tylenol®
Morphine: MS-Contin®, Oramorph®
Meperiding: Demerol®
Hydromorphone: Dilaudid®, Hydromorph Contin®
Hydrocodone: Novahistex DH®, Vicodin®
Oxycodone: Percocet®, Oxycontin®, Oxyneo®
Pentazocine: Talwin®
Fentanyl: Duragesic®
Propoxyphene: Darvon®, Darvocet®
Tramadol: Tramacet™, Zytram XL®
Opioids are commonly prescribed as pain relievers.
Sometimes referred to as narcotics, opioids effectively
change the way a person experiences pain. Morphine
Salvia Divinorum.
Effects: At higher doses, Dextromethorphan produces
dissociative effects similar to PCP and Ketamine. Longterm effects include liver damage due to the consumption of large quantities of acetaminophen.
Source: DEA
5-MeO-DIPT
Foxy methoxy, foxy, yum yum, roxy, dip foxy, muffy, five. 
A hallucinogenic tryptamine similar to Psilocybin.
Usually found as tablets with imprints similar to ecstasy
(heart, spider, alien heads, etc) or as capsules containing
bright-coloured powder. Tablets are swallowed while
capsule powders can be swallowed, smoked, or snorted.
Popular among young partygoers.
Effects:
•Hallucinations
•Euphoria
• Visual and auditory
distortions
• Dilated pupils
•Talkativeness
•Nausea
•Vomiting
•Diarrhea
• Muscle tension
• Jaw clenching
Source: Center for Substance Abuse Research
Salvia Divinorum
Diviner’s sage, magic mint, sage of the seers, salvia.
A hallucinogenic plant native to northeastern Mexico
that is part of the mint family. Dried leaves can be
smoked/vaporized then inhaled like marijuana or
chewed then swallowed.
Demerol 50mg
ratio-Oxycodan 5mg
Oxycontin 40mg
Dilaudid 4mg
Percocet 5mg
ratio-Fentanyl 16.5mg
Effects: Can last up to 15 minutes when smoked and
1–2 hours when chewed.
Common effects include:
•Hallucinations
• Slurred Speech
• Dizziness & nausea
• Decreased heart rate
• Lack of Coordination
•Chills
Tylenol 4 60mg
Talwin 50mg
ratio-Morphine
SR 30mg
Hydromorph
Contin 12mg
M–Eslon 60mg
Source: Center for Substance Abuse Research
1-(3-trifluoromethylphenyl) piperazine (TFMPP)
Legal E, legal X, A2.
A hallucinogenic piperazine typically used as an antiparasitic (de-worming) agent. Usually found as tablets
with imprints similar to ecstasy tablets (heart, spider,
alien heads, etc) or in capsules containing an off-white
powder.
Effects: Similar to MDMA, but taken in larger doses
promotes hallucinogenic reactions. Source: DEA
12
Codeine Contin 100mg
Dilaudid 4mg
Percodan 4.5mg
Oxycontin 20mg
Talwin NX 50mg
Vicodin 5mg
Fiorinal with
codeine 30mg
Codeine 15mg
Demerol
50mg
Oramorph 30mg
Source: DEA
13
Drug Identification Guide
is often used before or after surgery to alleviate severe
pain. Codeine is used for milder pain and as a cough
suppressant. Other examples of opioids that are often
prescribed include oxycodone, hydrocodone, hydromorphone (a long-acting painkiller), and meperidine (used
before and after surgery). Pentazocine produces effects
similar to oxycodone.
Sunshine Coast Health Center
since highly addictive, has limited medical use. Heroin
from Asia is typically a powder, which can vary in colour
from a white to dark brown powder. Black tar heroin, is
often sold in chunks weighing about an ounce and has
the colour and consistency of roofing tar or coal.
Actual photo of droopy eyes due to opioid use.
Source: California Highway Patrol
Heroin users often have “pinned” or constricted pupils that do
not respond to poor lighting. Other depressants often have
similar effects.
When misused, prescription pain relievers pills are
crushed to remove the sustained-release coating. This
allows for a rapid release of the medication and causes
a rush of euphoria similar to heroin. Crushed tablets can
be orally ingested, sniffed, or dissolved in water and
injected.
Recently, companies have began changing the formula
of certain opioid pain relievers to prevent misuse. For
example, Oxyneo® (Oxycodone) becomes a gummy substance when tampered with so that users cannot inject
or snort. Users, however, have reported ways around
this change (e.g. removing the pill’s outer coating which
causes the gummy-like substance). This change has also
not necessarily led to reduced misuse or addiction, but
increased use of illegally obtained prescriptions (e.g.
Fentanyl) and unregulated substances (e.g. heroin).
Effects:
Low Doses
•Dizziness
• Impaired concentration
•Drowsiness
•Nausea
• Droopy eyelids
• Slowed breathing
Large Doses
• Constricted pupils
• Slowed or stopped
breathing (may result in
• Cold, moist, and bluish
death)
skin
When these drugs are injected intravenously, there is
a surge of pleasure that surpasses hunger, pain, and
sexual urges. Taken orally, the effects are felt more
gradually.
Opium can be swallowed or smoked. Source: DEA
Track marks from an infection that has spread under the skin
due to needle injection.
of effects. Withdrawal symptoms include:
• Severe anxiety
• Profuse sweating
•Insomnia
•Tremors
• Muscle and bone pain • Cold flashes with goose
bumps
•Diarrhea
•
Kicking movements
•Vomiting
These symptoms can occur 4-5 hours after last dose.
The acute symptoms reach peak intensity after 36 to 72
hours and are usually over within 7 to 10 days.
Sources: DEA; NIDA InfoFacts.
Opium
Big O, black stuff, block.
An opiate or narcotic made from the white liquid in the
poppy plant with no current medical use. Used commercially as raw material for production of morphine
and codeine. Appears as a fine brownish powder, black/
brown tar-like substance, or liquid. Usually eaten or
smoked.
Effects: see prescription pain relievers.
Source: DEA
Long-term effects include:
• Severe constipation
•Moodiness
• Constricted pupils
• Menstrual irregularities
Heroin
Tolerance and physical dependence may develop fairly
rapidly with higher doses needed to maintain intensity
Derived from morphine and originally created as a cure
for opium addiction. Heroin is an effective painkiller but,
14
Heroin powder.
Big H, black tar, brown sugar, dope, horse, junk, mud,
smack.
A baggy containing black tar heroin. Source: California Highway
Patrol
Heroin can be used in a variety of ways depending
on user preference and the purity of the drug. Heroin
can be injected into a vein (“mainlining”) or a muscle,
smoked in a water pipe or standard pipe, mixed in a
marijuana joint or regular cigarette, inhaled as smoke
through a straw (“chasing the dragon”), or snorted
as powder. Heroin can also be injected under the skin
(“skin popping”). Heroin injection can be done either
by (1) the traditional method of heating heroin mixed
with water in a spoon over a flame (“cooking”) or by (2)
dropping the heroin powder and water directly into a
syringe, shaking the mixture to expedite dissolving of
solids, and applying flame from a lighter directly to the
syringe (“shake and bake”).
At safe-injection sites, a typical kit supplied to the heroin user will include: (1) a tourniquet (blue band) used
to raise arm veins; (2) a blue package of distilled water
Typical supplies provided at a safe-injection site include (from
left to right): metal vestibule (or “cooker”), alcohol swab, water
pack (blue container), rubber tie, and insulin syringe (needle).
Not visible is the small cotton filter that is placed in the cooker
to prevent solids from being drawn into the needle.
to dissolve the heroin; (3) a small aluminum vestibule
to mix, heat, and hold the mixture; (4) cotton filters
to prevent impurities being drawn into the needle; (5)
matches; (6) candles; and (7) an insulin syringe.
Effects: Similar to prescription pain relievers, but riskier
because the purity and contents of dose is not known to
the user. Heroin users often inject intravenously, which
increases the risk of harm due to (1) the substance (injecting any drug increases the likelihood of dependence,
15
Drug Identification Guide
Sunshine Coast Health Center
Fentanyl
Duragesic®, ratio-Fentanyl, Actiq® Lethal injection, drop
dead, fat Albert, the bomb, incredible hulk, greenies.
An “8-ball” of heroin.
experiencing psychosis, and overdose), (2) the injecting
behaviour (damage to skin and veins such as infections,
scars, abscesses, ulcers, collapsing veins, and possible
stroke if injecting into the neck), and (3) sharing injection equipment such as needles/syringes, spoons, and
filters (greater likelihood of spreading blood borne virus
infections such as Hepatitis B, Hepatitis C, and HIV).
Long-term effects include tolerance, withdrawal, and
physical dependence
(see prescription pain relievers).
Sources: DEA; NIDA InfoFacts, Heroin, April 2006
Methadone
Dolophine®
Can be legally prescribed in Canada by authorized doctors for the treatment of narcotic addiction and chronic
pain management. Methadose™, a stronger formula
(10 mg/ml), has been replacing Methadone (1 mg/ml)
since February 2014.
Short-term Effects: Can last up to 24 hours, thereby
permitting once-a-day oral administration for heroin
detoxification and maintenance programs.
Long-term Effects: Prolonged use can result in tolerance and dependence. Withdrawal is slower and less
severe, but more prolonged than heroin withdrawal.
With increased restrictions and changes in accessing
prescription opioids, such as Oxycodone, illicit Fentanyl
use has spiked in Canada. It is used knowingly and
unknowingly since Fentanyl is tasteless and scentless.
Substances, such as ecstasy, marijuana, and heroin, are
often found laced with Fentanyl. Fentanyl’s strength
and ability to go undetected in other substances has
resulted in a high percentage of overdoses and deaths
among users.
Effects: See opioid pain relievers.
PRESCRIPTION TRANQUILIZERS
& SLEEPING PILLS
Rohypnol is also a benzodiazepine used as a sleeping
pill. While not approved in Canada or the United States,
it is smuggled in primarily from Mexico. Rohypnol is
odourless, colourless, and tasteless and often used as
a “date rape” drug because it produces sedation and
memory loss.
Benzodiazepines are very dangerous when consumed
with other depressants such as alcohol.
Sources: DEA and NIDA InfoFacts
Xanax 1mg
Restoril 15mg
Dalmane 15mg
Valium 10mg
Restoril 30mg
Sources: DEA; NIDA InfoFacts
Inhalants
Air blast, bolt, boppers, buzz bomb, climax, glading (using
inhalant), gluey (person who sniffs or inhales glue),
hippie crack, kick, medusa, moon gas, oz, poor man’s pot,
poppers, quick silver, rush, shoot the breeze.
Contact cement is a common inhalant. Source: DEA
Ativan 1mg
Xanax 0.5mg
Effects: At lower doses, GHB can relieve anxiety and
produce relaxation. Combining use with other drugs
such as alcohol can result in nausea and difficulty
breathing. GHB may also produce withdrawal effects
including insomnia, anxiety, tremors, and sweating.
GHB is predominantly a depressant and produced as a
clear liquid, white powder, tablet, or capsule. It is colorless and odourless. GHB has a salty taste, but is virtually
undetectable when diluted in liquids. GHB is often
Benzodiazepines are prescription medications that slow
Ativan 2mg
GHB is a very thick liquid that forms air bubbles when
shaken. How thick a liquid (usually a beverage such as
fruit juice) is and how many air bubbles form can allow
users to determine how much (if any) GHB is present.
G, Georgia home boy, grievous bodily harm, liquid ecstasy.
Benzodiazepines used as sedatives: Temazepam
(Restoril®); Flurazepam (Dalmane®); Triazolam (Halcion®);
Flunitrazepam (Rohypnol®) Roofies, rope, the forget pill.
Serax 15mg
manufactured in homes with recipes and kits found and
purchased on the Internet.
GHB
Benzodiazepines used as tranquilizers:
Diazepam (Valium®), Oxazepam (Serax®), Lorazepam
(Ativan®), Alprazolam (Xanax®)
Valium 2mg
A variety of prescription tranquilizers and sleeping pills. Source: DEA
16
Used extensively for anaesthesia and analgesia.
Duragesic® and ratio-Fentanyl are transdermal patches
used in chronic pain management. Actiq® is intended
for opiate-tolerant individuals and is effective in treating breakthrough pain in cancer patients. Carfentanil
(Wildnil®) is used in veterinary practice to immobilize
certain large animals. Fentanyl is also available as a
white powder that is often mixed with other substances
to resemble prescription opioids such as Oxycodone or
Alprazolam. Can be smoked or snorted.
down brain function. They produce calm without sleep.
Benzodiazepines can also be used to aid sleep, but may
produce morning and daytime drowsiness. Benzodiazepines have replaced barbiturates in the treatment of
many disorders. Benzodiazepines are usually prescribed
to treat anxiety and nervousness, relax muscles, and
control certain types of muscle spasms. Benzodiazepines are recommended for short-term use only since
users can become dependent.
GHB is colourless, odourless, and when diluted is virtually
tasteless. Considered a “date rape drug.”
Inhalants are ordinary household and commercial
products used in one of three ways: (1) inhaled directly
from its container (“sniffing” or “snorting”), (2) placed
in a substance-soaked rag over nose and mouth and
inhaled (“huffing”), or (3) poured into a plastic bag
where the fumes are inhaled (“bagging”). Aerosols and
other pressurized liquids may be inhaled directly from
the container or out of an alternative container such
as a balloon filled with nitrous oxide. Some volatile
substances release intoxicating vapors when heated.
Many substances leave tell-tale stains or odors on
clothing. Their easy accessibility, low cost, and ease of
concealment makes them popular among youth. There
are hundreds of household products available today
that can be misused as inhalants. Examples of products
17
Drug Identification Guide
Sunshine Coast Health Center
Blood Alcohol Concentration (BAC) and Alcohol
Impairment
Blood alcohol concentration, or “BAC,” is a way to
determine the concentration of alcohol in a person’s
bloodstream. For example, a BAC of 0.04% means
0.04 grams of alcohol per 100 grams of blood. In most
provinces and states in North America, the BAC at which
a person is considered to be legally impaired is 0.08%.
BAC is the most common way for law enforcement to
determine whether a person can safely operate a motor
vehicle. BAC can be measured within 30 to 70 minutes
after a person has had a drink.
(Left) Fumes from rags soaked with liquid inhalants are inhaled from a bag in a process known as “huffing.” (Right) Like contact cement,
many inhalants are inhaled directly from their original container.
kids use to get high include model airplane glue, nail
polish remover, cleaning fluids, hair spray, gasoline, the
propellant in aerosol whipped cream, spray paint, and
cooking spray.
Effects: Within seconds of inhalation, the user experiences intoxication along with other effects similar to
those produced by alcohol. Alcohol-like effects may
include slurred speech, poor coordination, dizziness,
confusion, and delirium. Nausea, vomiting, light-headedness, hallucinations, and delusions are other common
side effects.
Sources: DEA; NIDA InfoFacts
ALCOHOL (ethyl alcohol or ethanol)
Beer, spirits, wine, coolers, hard liquor, liqueurs, booze,
moonshine, shooters, brew, hooch.
Alcohol is produced naturally by fermentation of fruits,
vegetables, or grains. One shot (1 oz) of distilled spirits
(40% alcohol) has the same amount of alcohol as one
5-ounce glass of wine (13% alcohol) or one 12-ounce
beer (5% alcohol) (see image on p. 19). Alcohol is also
found in many toiletries (e.g. mouth wash and after
shave), cooking products (vanilla extract) and household cleaners (Lysol®). Alcohol is a contributing factor in
many drug overdoses.
18
Effects:
Low Doses
•Euphoria
•Drowsiness
•Dizziness
Large Doses
• Slurred speech
•Staggering
Typical Effects
Predictable Effects on
Driving
.02%
• Some loss of judgment
• Relaxation
• Slight body warmth
• Altered mood
• Decline in visual functions
(rapid tracking of a moving
target)
• Decline in ability to perform
two tasks at the same time
(divided attention)
.05%
• Exaggerated behavior
• May have loss of smallmuscle control (e.g., focusing
your eyes)
• Impaired judgment
• Usually good feeling
• Lowered alertness
• Release of inhibition
• Reduced coordination
• Reduced ability to track
moving objects
• Difficulty steering
• Reduced response to
emergency driving situations
.08%
• Muscle coordination becomes
poor (e.g., balance, speech,
vision, reaction time, and
hearing)
• Harder to detect danger
• Judgment, self-control,
reasoning, and memory are
impaired
•Flushing
• Lowered inhibitions
• Double vision
•Stupor
A “hangover” (e.g. headache, nausea, shakiness and
vomiting) may begin 8 to 12 hours after a period of excessive drinking. Long-term effects of daily drinking can
lead to liver damage, brain damage, heart disease, loss
of memory, ulcers, pancreatic disorders, and infertility.
Chronic drinkers are likely to become physically and
psychologically dependent. Withdrawal symptoms may
include:
•Tremors
• Faster heart rate
•Agitation
•Seizures
•Anxiety
• Delirium tremens
• Panic attacks
•Hallucinations
• Elevated blood pressure
Source: Health Canada
Blood Alcohol Concentration (BAC)
• Concentration
• Short-term memory loss
• Speed control
• Reduced information
processing capability (e.g.,
signal detection, visual search)
• Impaired perception
.10%
Different beverages with the same amount of alcohol.
The rate at which alcohol enters the bloodstream may
vary depending on (1) the number of drinks consumed,
(2) how fast you drink, (3) the amount of food in your
stomach (food slows absorption), (4) your weight, and
(5) gender. As a general rule of thumb, the average
person will eliminate 0.5 ounces (15 ml) of alcohol per
hour. Factors such as age and gender affect the body’s
ability to metabolize alcohol. The chart to the right
shows common symptoms people exhibit at various
BAC levels and the effects on a driver/operator of a
motor vehicle.
• Clear deterioration of reaction • Reduced ability to maintain
lane position and brake
time and control
appropriately
• Slurred speech, poor
coordination, and slowed
thinking
.15%
• Far less muscle control than
normal
• Vomiting may occur (unless
this level is reached slowly
or a person has developed a
tolerance for alcohol)
• Major loss of balance
• Substantial impairment in
vehicle control, attention to
driving task, and in necessary
visual and
auditory information
processing
Source: National Highway Traffic Safety Administration (NHTSA)
Caution: alcohol intoxication can amplify the effects of medication, fatigue and mood states such as depression. Extra care is recommended
when operating a motor vehicle or heavy equipment.
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Drug Identification Guide
Sunshine Coast Health Center
Class 3
STIMULANTS
Cocaine
Big C, blow, coke, flake, freebase, lady, nose candy, rock,
snow, snowbirds, crack, white crack.
Cocaine is a drug extracted from leaves of the coca plant.
It is a potent brain stimulant and one of the most powerfully addictive drugs. Cocaine is distributed on the street
in two main forms: cocaine hydrochloride and “crack”
cocaine. Cocaine hydrochloride is a fine powder often diluted with sugar, cornstarch, or talcum powder. Cocaine
hydrochloride is usually snorted or dissolved in water and
injected. “Crack,” the “rock” form of cocaine, is a smokable
form of cocaine made by adding baking soda to a cocaine
solution and allowing the mixture to dry.
Effects: Cocaine’s intensity depends on the dose
and rate of entry to the brain. When snorted, cocaine
reaches the brain in 3–5 minutes. Intravenously
injecting cocaine produces a rush in 15 to 30 seconds
and smoking produces an almost immediate intense
experience. However, the faster the absorption, the
shorter the high lasts. The high from snorting may last
15 to 30 minutes, while that from smoking may last 5
to 10 minutes. Once the drug leaves the brain, the user
experiences a “coke crash” that includes depression,
irritability, and fatigue. To avoid withdrawal, frequent
and repeated doses are taken.
Long-term effects or high doses of cocaine can trigger
paranoia. Smoking crack cocaine can produce particu-
Crack cocaine is different from cocaine powder since it is typically smoked and has a shorter but stronger euphoric effect.
larly aggressive paranoia behaviours in users. When
addicted individuals stop using cocaine, they often
become depressed. Prolonged cocaine snorting can
result in ulcers in the nose.
Injectable cocaine users are at risk for infections such as
hepatitis and HIV. There is some evidence that people
who use cocaine may participate in HIV-related risky
behaviours, such as sharing needles and unprotected
sex, more often than people who inject other types of
drugs.
Sources: DEA; NIDA InfoFacts
Actual photo of dilated pupils due to stimulant effect.
Prescription Stimulants
Adderall®; Dexedrine®, (dexies); Ritalin® (kibbles and
bits, pineapple); Tenuate®; Ionamin®
that enhance brain activity. Medically, they are now
prescribed for only a few health conditions. Ritalin, Adderall, and Dexedrine are used to treat attention deficit
disorders (ADHD and ADD). Prescriptions are commonly
sold illegally to high school and college students trying
to focus while studying for exams. Ritalin, Adderall,
and Dexedrine are also prescribed to treat narcolepsy.
Tenuate, Ionamin and Dexedrine have limited use as an
aid in treating obesity.
Effects:
• Nervousness and
insomnia
• Loss of appetite
• Nausea and vomiting
•Dizziness
•Palpitations
•Headaches
Long-term Effects:
• Compulsive use
• Feelings of hostility
•Paranoia
•Hallucinations
• Changes in heart rate
and blood pressure
• Skin rashes and itching
• Abdominal pain
• Weight loss and
digestive problems
• Toxic psychosis and
psychotic episodes
• Excessive repetition of
movements
• Formication (sensation
of bugs and worms
crawling under the skin)
Dexedrine 10mg
Ritalin 10mg
Adderall XR 15mg
Tenuate 25mg
Biphentin 10mg
Dexedrine 5mg
Source: DEA
A class of drugs usually found in tablets and capsules
Ionamin 15mg
Ritalin SR 20mg
Concerta 36mg
Cocaine powder is chopped with a razor blade to a fine grain then snorted using a straw, small spoon or a rolled-up bill.
20
21
Drug Identification Guide
Sunshine Coast Health Center
Taking high doses of a stimulant may result in
dangerously high body temperatures and an irregular
heartbeat. There is also the potential for heart failure or
lethal seizures.
Effects: Methcathinone produces amphetamine-like
activity. Long-term effects are unknown.
Source: DEA, Indiana Prevention Resource Center (IPRC)
(Catha edulis) qat, kat
Source: DEA
Khat
Meth-Amphetamine
For centuries, Khat, the fresh young leaves of the Catha
edulis shrub, has been consumed in East Africa and the
Arabian Peninsula. It contains a number of chemicals
among which are two controlled substances, cathinone
and cathine.
Desoxyn®, chalk, crank, croak, crypto, crystal, crystal
meth, fire, glass, meth, tweek, tina, white cross, shard, ice.
Methamphetamine (“meth”) is an addictive stimulant
that activates certain systems in the brain. “Crystal
meth” is a pure, smokeable form of methamphetamine
that looks like clear crystal chunks or ice. It is usually
white or slightly yellow, depending on the purity.
Effects: Crystal meth has similar effects to cocaine, but
longer. Immediately after smoking or injection, users
experience an intense sensation—or a “rush”—that
lasts only a few minutes. Snorting or swallowing meth
produces a less intense euphoria and after the initial
“rush,” there is usually a state of high agitation that can
lead to violent behaviour.
“Meth mouth.” Source: Christopher Heringlake
Other Possible Effects Include:
• Increased wakefulness •Nervousness
and insomnia
•Convulsions
• Decreased appetite
• Heart attack
•Anxiety
Long-term effects include tolerance and dependence. In
some cases, users forego food, sleep, and hygiene and
take meth every few hours for days (“binging”) until
Ice. Source: DEA
they run out of the drug or become too disorganized
to continue. Smoking can also lead to “meth mouth”:
permanently damaged teeth and gums caused by inhaling ingredients used to make amphetamine (anhydrous
ammonia, battery acid, drain cleaner, camp fuel, etc).
Chronic use can cause paranoia, hallucinations, repetitive behaviour (e.g. compulsive cleaning, grooming,
or disassembling/assembling objects), and delusions
of parasites or insects crawling under the skin. Users
may obsessively scratch their skin to get rid of these
imagined insects. High dosages can bring on full-blown
toxic psychosis (often exhibited as violent, aggressive
behaviour) and extreme paranoia. Meth can also cause
strokes and death.
Khat is typically chewed like tobacco. The fresh leaves,
twigs, and shoots of the khat shrub are chewed and
then retained in the cheek, where they are chewed
intermittently to release the active drug. Dried Khat
can be made into tea or a chewable paste, but it is not
as potent as the fresh plant product. Khat can also be
smoked and even sprinkled on food.
Effects: Compulsive use may result in aggressive
behaviour with grandiose delusions. Psychological
dependence may result from continued use. Withdrawal
symptoms include:
•Lethargy
•Depression
• Nightmares and tremors
Long-term effects are unknown.
Source: DEA
Sources: DEA; NIDA InfoFacts
Methcathinone
Cat
Crystal meth. Source: DEA
22
Methacathinone is a white or off-white crystalline
powder most commonly snorted, although it can be
taken orally when mixed with a beverage or injected
intravenously when diluted in water. This stimulant is
structurally similar to Methamphetamine and Cathinone. It is manufactured from readily available chemicals and occasionally confused with Khat (they share a
similar chemical structure). The addictive properties and
side effects of this synthetic drug are more intense than
that of Khat substances.
Khat is often chewed. Source: DEA
23
Drug Identification Guide
Sunshine Coast Health Center
Class 4
Class 5
Anabolic Steroids
Marijuana
ANABOLIC STEROIDS
CANNABIS
Juice, rhoids.
A group of powerful compounds closely related to the
male sex hormone testosterone. Current legitimate
medical uses include treatment of certain kinds of anaemia. Body builders and many competitive athletes claim
that steroids give them a competitive advantage and/
or improve their physical appearance. Steroids are taken
orally or injected. Users frequently combine several
different types of steroids to maximize their effectiveness while minimizing negative effects. This process is
known as “stacking.”
Effects:
• Increases in lean muscle • Ability to train longer
mass
and harder
•Strength
Long-term Effects:
• Liver tumours
•Jaundice
Boom, chronic, dope, joint, blunts, ganja, grass, hash,
herb, Mary Jane, pot, reefer, skunk, weed.
Winstrol 2mg
Anadrol 50mg
Oxandrin 2.5mg
Android 25mg
Source: DEA
Hashish or hash oil
Hash, oil, honey oil.
Products of the hemp plant, Cannabis sativa. The main
active chemical in marijuana and hashish is THC (Tetrahydro-cannabinol, Marinol, delta-9-tetrahydrocannabinol). Hashish is a reddish brown or black coloured
THC-rich resinous material. Hashish is collected, dried,
and then compressed into a variety of forms such as
balls, cakes, or cookie-like sheets. Hash oil is the refined
extract of the cannabis plant and varies in colour from
amber to dark green or brown.
• Fluid retention
• High blood pressure
Additional side effects:
Men
• Shrunken testicles
• Male-pattern balding
• Reduced sperm count
• Development of breasts
•Infertility
Women
• Growth of facial hair
• Deepened voice
Adolescents
• Halted growth due
to premature skeletal
maturation
• Changes in or cessation
of the menstrual cycle
• Accelerated puberty
changes
24
Cannabis Oil, Wax, & Shatter
Concentrated oil forms of THC extracted from marijuana’s main ingredients. Cannabis oil is the least refined
concentrate that comes as a gooey, sticky liquid. Shatter
has a peanut brittle or taffy-like appearance (smooth,
clear, and solid) and is the most potent concentrate
since fats, lipids, and waxes have been removed. Wax or
budder has a soft, creamy consistency due to cannabinoids crystallizing. Because of these products’ higher
potency, users require much less than standard marijuana to experience a high. Psychosis and brain damage
can be a result of exposure to high THC concentrates.
Medical Use
Cannabis for medical purposes has been under frequent
debate in North America. All forms of cannabis can
be used by medical patients who generally use it for
managing conditions such as pain and nausea.
Testosterone Cypionate 200mg/ml. Source: DEA
Researchers report that users may suffer from paranoid
jealousy, extreme irritability (“roid rage”), delusions,
and impaired judgment stemming from feelings of
invincibility.
Long-term effects or high-dose effects of steroid use are
largely unknown.
Sources: DEA; NIDA InfoFacts
A bud of marijuana.
Top to bottom: Cannabis shatter, wax and oil.
Effects:
• Memory and learning • Increased heart rate
problems
•Anxiety
• Distorted senses
• Dry mouth and throat
• Loss of motor coordination
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Drug Identification Guide
Sunshine Coast Health Center
Hash oil applied to rolling paper and rolled with tobacco (or
marijuana).
Spice or K2
These effects are even greater when other drugs are
mixed with marijuana. Studies have shown that a single
marijuana joint can cause more damage than 2.5 – 5
cigarettes and result in chronic bronchitis and airflow
obstruction1. This comparatively greater damage of
cannabis may be explained, in part, by the way it is
smoked—without a filter, to a shorter butt length
(“roach”), deeper inhalation, and delayed exhalation.
Studies have shown a link between marijuana and
psychotic disorders, particularly schizophrenia2.
Spice—or “synthetic marijuana”—is typically sold as
drive leaves (similar to potpourri) in small, plastic bags
and smoked in a pipe or joint. Sometimes it is mixed
with marijuana or infused into drinks.
Source:
1 Aldington S, et al. (2007). Effects of cannabis on pulmonary structure, function and symptoms.
2 Castle, D. J., & Murray, R. (2004). Marijuana and Madness.
Chunks of hashish stored in a “stash box.”
26
a “joint”. Marijuana can also be smoked in a bong or a
blunt (a pre-made, hollow tobacco leaf product with
a pre-fabricated filter on one end). These products are
commonly sold in tobacco shops across North America.
Hash oil is mixed with tobacco or marijuana as a joint
or applied directly to a glass pipe and smoked. With
increased THC content in marijuana, the demand for
hashish and hash oil has diminished.
Hashish pieces are broken off, placed in a metal or glass
pot pipe and smoked. It can also be smoked by heating
two table knives until they are red hot then squeezing
the hash between them (look for black burn marks)
and inhaling the smoke through a plastic pop bottle
with the bottom removed. Many of the same methods
used to smoke marijuana can also be applied to hash.
Hashish is sometimes mixed into food, most commonly
as “hash brownies”.
Other cannabis paraphernalia includes rolling papers
(e.g. Zig Zag brand), scissors (look for sticky resin on
scissor blade from chopping marijuana), herb grinders
(to break up the marijuana bud so it can be rolled into a
joint), roach clips (small alligator clips to hold the joint
butt to prevent finger burns), and film canisters (used to
keep marijuana and hash moist and conceal the smell).
Smoke shops sell a variety of storage devices and pipes
that are disguised as regular household items and food
products.
Bliss, black mamba, fake weed, genie.
Effects:
• Increased heart rate and • Altered perceptions
blood pressure
• Paranoia and panic
• Elevated mood and
attacks
giddiness
•Hallucinations
•Relaxation
Long term effects are unknown.
Source: Streetdrugs, NIDA
Cannabis Paraphernalia: Marijuana is typically
smoked. Most users roll marijuana into a cigarette called
Blunts are flavoured, pre-fabricated hollow tobacco leaves that
are stuffed with marijuana then smoked.
Ceramic, glass, and metal pipes (from left to right) for smoking pot or hash. The ceramic pipe resembling a cigarette is a type of pipe
(often called a “one-hitter,” or “hitter”) that is used when smoking pot in public.
More pipes (from left to right) for smoking pot including a glass
“bong,” a glass “chillum,” and a converted pop can.
Smoke shops sell many products disguised as consumer products designed to conceal (i.e. pop can with inside storage) or
consume (i.e. highlighter that doubles as a pot pipe) drugs.
27
Drug Identification Guide
Drug Paraphernalia
Sunshine Coast Health Center
substance while it is being heated:
Drug paraphernalia is any equipment, product, or material modified for making, using, or concealing illegal
drugs.
• Metal foil
• Glass or metal smoking
pipe
• Misc. items such as pop
can, bottle cap, broken
light bulb
Drug Containers: Many drugs sold in powder form
are often sold in “flaps” (small square pieces of magazine or lottery paper folded into an envelope). Other
containers include small glass vials, re-sealable plastic
baggies, and tiny sacks called “8-balls”.
The fumes are then inhaled directly from the pipe using
a hollow hard plastic or glass tube. Crystal meth and
crack cocaine do not burn on their own so a flame has to
be held to these drug during inhalation. When cocaine
is smoked it leaves a white residue (most noticeable
where the vapour is delivered to the mouthpiece).
Refer to the Cannabis Drug Paraphernalia Section (p.
26) for information on marijuana, hashish, or hashish oil
paraphernalia.
Injected Drugs: To prevent spillage, spoons are the
primary device to hold injectable substances while
being heated. Disposable syringes are used to inject the
liquid and often contain trace amounts of blood. Elas-
An “8-ball” of cocaine powder. Package is made from small
squares of garbage bag plastic that are bound tight with dental
floss. Any excess material above the dental floss is cut off using
scissors.
8-balls are used when drug dealers work in close
proximity to law enforcement. 8-balls are small, tight
and round to make it easier to swallow and avoid detection. There are two layers of garbage bag to prevent the
package from exploding in the stomach if the product
has to be quickly swallowed or kept from getting wet
since dealers often hide 8-balls between the cheek and
gum. Heroin 8-balls are typically in black garbage bags
while cocaine 8-balls are sold in white garbage bags.
Another advantage of 8-balls for dealers is that users
often end up using the drug in one session since the
package design makes it impossible to reuse the wrapping once it is opened.
Crack paraphernalia includes (from l to r) a used crack pipe
fitted with a mouthpiece, a small and large glass tube (“straight
shooter”), yellow plastic mouth piece to prevent lip burns,
brillo pad (filter), a pipe cleaner, and a poker for air passage.
28
Snorted Drugs: Powders can be “snorted” (inhaled)
up the nostril via a thin straw or tiny “coke” spoon (holds
powder under the nose). Another common method
of snorting is using a rolled up bill as a straw. Powder
cocaine is often “cut” into lines with a razor blade and
then snorted on a mirror or glass surface.
Oral Drugs: Prescription drugs often come in capsule,
tablet, or liquid form (look for empty cough medicine
bottles). Club drugs often come in tablets with a rough
edge and imprint (such as a Nike swoosh or butterfly)
that resemble children’s candy. Club drug users often
experience involuntary jaw clenching and use baby
soothers to ease it.
First Aid for a Drug
Overdose
Remember, when someone overdoses their body
is responding just like it would to any other poison.
Poisonous consumer products (such as inhalants) have
poison symbols on their labels, but there are many other
substances that don’t carry warnings. Examples include
alcohol, unregulated substances, and medications when
not taken as prescribed. Many drugs that are not harmful in small amounts are poisonous in large amounts.
Types of Drug Overdoses
The three types of drug overdoses are classified
according to how they enter the body:
• swallowed drugs – through the mouth
• inhaled drugs – through the lungs
• injected drugs – through the skin using a hollow
needle
Drugs usually sold in liquid form include GHB and
steroids. Look for small glass bottles or plastic squeeze
bottles.
Smoked Drugs: Drugs sold as powders are often
smoked. For example, PCP, heroin, crack cocaine, and
crystal meth require various devices used to hold the
tics, rubber ties, or surgical tubing are used to inflate the
vein for easier injection. Users often wear long-sleeved
shirts to cover track marks on arms.
Crystal meth paraphernalia includes (from left to right) a torch
lighter, meth pipe, a test tube converted into a meth pipe, and
a broken light bulb.
An important part of first aid for drug overdoses is
contacting the Poison Information Centre for advice on
what to do. Before calling, the first aider must quickly
gather as much information about the incident as possible. Use the scene and the person’s signs and symptoms to gather the information you’ll need to answer
Various packages for storing powder drugs. “Flaps” are small
envelopes made from folded squares of lottery paper or glossy
magazine stock that will not stick to the substance. Small ziploc bags (“baggies”) are used for powder and rocks.
the questions asked by the Poison Information Centre.
History of the Scene
When drug overdosing occurs, act quickly but do not
panic. You need to know four basic facts to give appropriate first aid for a drug overdose:
• What drug was taken – Container labels may
identify the drug. Otherwise, save vomit and give it to
medical attendants for analysis.
• How much drug was taken – Estimate the quantity
that may have been taken based on what you see or
are told (The number of pills originally in the container, the amount of drug in the bottle, etc). Estimate
the size/age of the user.
• How the drug entered the body – First aid may
differ for drugs taken by the mouth, injected into the
blood, or breathed into the lungs.
• When the drug was taken – The length of time the
drug has been in the body will help determine the first
aid and medical care needed.
Signs and Symptoms of a Drug Overdose
If the history does not reveal what drug was used or
how it was taken, signs and symptoms may be helpful
in answering these questions. All drugs affect
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Drug Identification Guide
Sunshine Coast Health Center
consciousness, breathing, and circulation. Other signs
and symptoms may vary depending on how the drug
was taken. Drugs that have been:
4 Give ongoing care until medical help takes over.
• Swallowed usually cause nausea, abdominal cramps,
diarrhea and vomiting. They may discolour the lips,
cause burns in or around the mouth or leave an odour
on the breath.
Tips to Help Reduce the Risk of Overdose
If you or a loved one use depressant drugs like heroin,
the following tips will help you reduce the risk of
overdose:
• Avoid using other drugs, especially sedatives or alcohol, on the same day
• Injected through the skin usually irritate the point
of entry and may cause an allergic or behavioural
reaction.
• Inhaled may cause problems with breathing. Signs
and symptoms may include coughing, chest pain, and
difficulty breathing. Prolonged lack of oxygen will
cause headache, dizziness, unconsciousness, stopped
breathing and cardiac arrest.
General First Aid for a Drug Overdose
1 Begin Emergency Site Management (ESM) – do
a scene survey. Gather any information about the
suspected drug. Determine the user’s responsiveness.
•If the casualty is responsive, call the Poison Information Centre in your region or your hospital emergency
department. Answer any questions and follow their
advice on first aid.
•If the casualty is unresponsive, call 911 immediately
and go to step 2.
2 Do a primary survey. If breathing is stopped begin
CPR. Check for poisonous material around the mouth
first. Use a barrier device if you have one.
3 Place the unconscious, breathing person into the
recovery position (see below).
The recovery position.
30
Extracted and revised from “First on the Scene: the Complete Guide to
First Aid and CPR”, 2000.
•Use a small amount and always have a trial “taste” of a
new batch
•Have someone with you when you are using
•Avoid injecting in places where no-one can get to you
if you do overdose
•Know the telephone numbers of the ambulance
service
•If possible, have the anti-overdose drug, Naloxone,
nearby and accessible when using depressants,
especially opioids and opiates
A Final Note on Naloxone
Naloxone is a safe, highly effective chemical compound—also called an “opioid antagonist”—that
reverses the effects of opioids (e.g. oxycodone) and opiates (e.g. heroin). It is used as an emergency treatment
for opiate overdose. In the USA and Europe, Take Home
Naloxone programs have been linked with reductions in
drug deaths of up to 34%. Naloxone has been approved
for use in Canada for over 40 years and has no potential
for misuse since it exhibits essentially no pharmacologic
activity in the absence of narcotics.
Naloxone will work only for drugs in the opiate/opioid
family—it is not effective for overdoses of other drugs
such as cocaine. Access to Naloxone varies in Canada,
including take-home doses for people who use illicit
drugs in Edmonton and Toronto. Although traditionally administered by emergency response personnel,
Naloxone can be administered by minimally trained laypeople, making it ideal for treating overdose in people
who have been prescribed opioid pain medication and
in people who use heroin and other opioids.
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At Sunshine Coast Health Center we are committed to a client’s personal
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with a renewed sense of vitality and purpose.
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2174 Fleury Road, Powell River, BC
Canada V8A 0H8
Admissions Toll Free 866.487.9010
Administration Toll Free 866.487.9050
Fax: 604.487.9012
www.schc.ca | [email protected]